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Texas prisons and jails have been coronavirus hot spots throughout the pandemic. At least about 200 Texas inmates have died with COVID-19. So have more than 30 people who worked inside the states prisons and countless others have spread the virus inside lockups and into the surrounding communities.
But its unclear when the still-limited doses of virus vaccines will be made available to the more than 186,000 people detained in Texas prisons and jails. That timeline is among several factors Texas prison officials either havent decided or havent publicly released more than nine months into the pandemic and weeks after leaders knew a vaccine was on the horizon.
And if the doses remain voluntary once they do arrive for inmates, lockup staff will need to convince incarcerated people many of whom are skeptical of prison medical care to get the shot.
In Texas, health care workers and people in long-term care facilities like nursing homes are at the front of the line to receive the vaccine. Several states have earmarked doses for the incarcerated soon after those initial groups of health care workers and first responders. Because of the disease-prone environment they live and work in, advocates in the state and throughout the country have urged officials to prioritize inmates and corrections staff to get the coronavirus vaccine rapidly.
But Texas officials have so far remained largely silent on when people behind bars may receive the doses.
At a press conference last week, Gov. Greg Abbott skirted a reporters question about when prisoners would get the vaccine. And a Texas Department of Criminal Justice spokesperson declined to answer questions on how and when the vaccine would be distributed in the state prison system, referring questions to the governors office and the University of Texas Medical Branch, which is handling vaccine distribution for the state prison system.
Though seven Texas prisons were set to receive 1,100 doses this week, according to the state health departments weekly distribution list, a UTMB spokesperson said that only health care workers at the units were in line to get the shot so far.
Spokespeople for the governor did not respond to repeated questions since last week, including whether the second-phase of people to receive the vaccine those 65 and older or with certain chronic medical conditions will include inmates that fall into those categories as well. A health department spokesperson said anyone 65 and older will be eligible for the vaccine.
Whenever the doses do arrive for inmates and other staff, however, the lockups will likely need to convince at least some of them to sign up for the vaccine if it isnt mandatory. A spokesperson for the state health department said Tuesday that the vaccine can't yet be required because it has so far only been authorized for emergency use. A Harris County jail spokesperson said last week that, at this time, vaccines will be voluntary for jail inmates when they become available. A spokesperson for TDCJ did not know as of Tuesday if the vaccine would be voluntary for its prisoners.
The governor has said previously that the shot will be voluntary for everyone. His office did not respond to questions on if that would apply to prisons and jails, too.
Prisoner advocates said there is a lot of fear and distrust of the vaccine from inmates and their loved ones on the outside. Its a wariness that many people in the free world feel as well with the rapidly developed vaccine. But prison health and condition experts said there are multiple reasons that exaggerate the skepticism, from a history of medical experimentation on prisoners to a lack of information in lockups.
It speaks to the incredible distrust that exists inside prisons of medical care and whether people feel like theyre being treated with dignity or respect and whether anyone cares about their safety, said Michele Deitch, a senior lecturer and prison conditions expert at the University of Texas' LBJ School of Public Affairs and law school. I dont think its justified, its just understandable.
Inmates and their family members have referred to prison experiments where, in the last century, prisoners in the United States have been infected with viruses or bacteria to monitor symptoms or test treatments. Often, among the Black community, the infamous Tuskegee syphilis study is cited, where Black men with syphilis were untreated and instead monitored to track the fatal path of the disease.
Lovinah Igbanis fianc, a Texas inmate, is among the wary.
He feels like he may become a victim to the science, Igbani said.
Igbani has been trying to convince her fianc to get the vaccine, but she said he goes back and forth. She faults the eroded relationships between prison medical staff and inmates and the rumor mill that can spread misinformation as quickly as the virus.
In prison, theres so much conversation about it right now, and so many of them are like, Dont do that, its just a trick, theyre trying to kill us, she said. Its not enough to try to just educate one person.
Igbani and prisoner advocates have urged the prison agency to hold an education campaign to prelude the vaccination. She said they need to know theyre not going to be guinea pigs and that this vaccine has been tested.
[My fianc] heard my doctor here of 10 years saying hes going to get it next weekend and encouraged me [to get it], she said. To me, that can be very reassuring.
After she talked to him about the doctors appointment, her fianc said he would get the shot when it was available. But two days later, hed changed his mind again, after hearing too much fear from other prisoners inside.
A spokesperson for TDCJ said last week the prisons communication department was creating a campaign to tout the vaccine as the best way to stop the virus. Several advocates have suggested the prisons already existing peer education program, where inmates are given the tools and knowledge to inform and engage with other prisoners on issues like sexual assault reporting and Hepatitis C.
They cultivate a clear line of distrust between officers and staff and incarcerated individuals, said Doug Smith, senior policy analyst at the Texas Criminal Justice Coalition who also worked as a peer educator when he was imprisoned in TDCJ. Peer to peer is going to be critical setting up, preparing peer educators to just do education about what the vaccine is.
But just as experts say the skepticism of the vaccine is exaggerated in prison, so is the desperation for it. Many prisoners have been largely kept to their cells for months during outbreaks, they have been unable to see their friends and families in person since March and they have often been sickened themselves and witnessed the virus fatal impact first hand.
Theres enough experience that a lot of people have to be really distrustful, but a lot of them have seen friends die, Smith said.
Some experts are more worried about staff resistance to the vaccine. Deitch said questions remain on whether corrections officers will need to be vaccinated to be able to work with vulnerable populations of inmates. And units often become infected because of officers who bring the virus in, noted John Eason, an associate professor of sociology at the University of Wisconsin and director of the universitys Justice Lab who is studying prison and community spread of the virus.
Were seeing a move from community, to staff, to prisoners and then back from prisoners to community, he said.
MONONGAHELA, Pa. (KDKA) As coronavirus vaccines reach the arms of more health care workers across the country, Pennsylvania Secretary of Health Dr. Rachel Levine is encouraging hospitals to take the next steps of their role in the supply chain.
My message today to hospitals is to start to reach out and to work together with EMS providers and agencies, as well as other non-affiliated health care providers and work to get them vaccinated as soon as possible, she said at a Wednesday press conference.
Levine says the Pennsylvania Department of Health is encouraged by the number of vaccines available, especially with the recent authorization of the Moderna vaccine for emergency use.
The states vaccination plan is taking off in the Mon Valley and already getting vaccines to local first responders.
A spokesperson for Monongahela Valley Hospital told KDKA that the hospital had adequate doses of the vaccine to give to employees and distributed vaccines to first responders in the community.
The Charleroi Fire Department is one of the agencies that received the vaccine from the hospital.
Its a light at the end of the tunnel, said Chief Robert Whiten Jr.
Whiten said he got a call from Mon Valley Hospital telling him that doses were available. Nineteen firefighters within the department received the first of two coronavirus shots while 16 others are still waiting.
You want to keep the guys safe, and we sanitize our fire station twice a week, Whiten says of running the department over the past nine months. It does get frustrating, but Im hoping with the shot, maybe well get back to some normalcy here.
Mink, like people, often die from infection with the virus, and nobody knows why. This is a key thing, Dr. Perlman said. Why do people get sick? Why do we react so differently to these viruses. He said he had thought about studying mink, but the challenges, involving their genetic diversity and the lack of an established set of biochemical tools for studying infections in them, made the prospect difficult.
Dec. 23, 2020, 8:46 p.m. ET
Some parts of the mink puzzle fit easily together. They live in crowded conditions in rows of cages on mink farms, like people in cities, and are in constant contact with the humans who care for them. No surprise then, that they not only caught the virus from people, they passed it back to us.
And the infection of mink and the potential danger they pose is a reminder that it isnt only wild animals that are the cause of spillover events. The livestock humans housed in close quarters have always given diseases to humans, and acquired diseases from them. But it required big human settlements for epidemics and pandemics to appear.
In a 2007 paper in the journal Nature, several infectious disease experts including Jared Diamond, the author of Guns, Germs and Steel: The Fate of Human Societies wrote about the origins of diseases that spread only in relatively dense human populations. Measles, rubella and pertussis, they wrote, are examples of crowd diseases that need populations of several hundred thousand for a sustained spread. Human groups of that size did not appear until the advent of agriculture, around 11,000 years ago.
The authors listed eight diseases of temperate regions that jumped to humans from domestic animals: diphtheria, influenza A, measles, mumps, pertussis, rotavirus, smallpox, tuberculosis. In the tropics, more diseases came from wild animals, for a variety of reasons, the authors wrote.
Diseases move from wild animals to farmed animals and then to people. Influenza viruses jump from wild waterfowl to domestic birds and sometimes to pigs and then to people who are in close contact with the farmed creatures. As occurred with the mink, the viruses continue to mutate in other animals.
There may have even been an earlier coronavirus epidemic that came from cattle. Some scientists have speculated that one of the coronaviruses that now causes the common cold, OC43, may have been responsible for the flu epidemic of 1889, which killed a million people.
Cars are lined up at Dodger Stadium in Los Angeles for coronavirus testing. Nearly 2 million people are getting tested a day in the U.S. A new analysis shows millions more are needed to protect the most vulnerable. Mario Tama/Getty Images hide caption
Cars are lined up at Dodger Stadium in Los Angeles for coronavirus testing. Nearly 2 million people are getting tested a day in the U.S. A new analysis shows millions more are needed to protect the most vulnerable.
The nation is at a pivotal moment in the fight against the pandemic. Vaccines are finally starting to roll out, but the virus is spreading faster than ever and killing thousands of Americans daily. And it will be months before enough people get inoculated to stop it.
That means it's critical to continue the measures that can limit the toll: mask-wearing, hunkering down, hand-washing, testing and contact tracing.
"Vaccines will not obviate the need for testing any time soon," says Dr. Ashish Jha, the dean of the Brown School of Public Health. "It doesn't mean we can let our guard down. The virus will not be gone."
So where do things stand with testing in the U.S.?
A new analysis that researchers at Brown and Harvard universities conducted for NPR finds that the country may finally be close to doing enough testing to identify most people reporting symptoms and at least two of their close contacts.
The amount needed for that is 2 million a day by Jan. 1. The U.S. is currently conducting nearly 1.9 million tests daily.
Testing simply those who are sick and two of their contacts is a bare minimum to respond to current outbreaks, Jha explains.
The analysis finds that the U.S. should be doing about three times more than that or nearly 6 million daily tests to stop outbreaks from growing and protect the most vulnerable. This approach would proactively screen key groups of asymptomatic people, including college students and school teachers, for example.
"There's no doubt that we've made progress," says Jha. "But testing in this country is still really inadequate."
Even that progress is spotty around the country. Only 12 states plus Washington, D.C., are conducting enough testing to reach the bulk of symptomatic people, according to the analysis. Those states are: Alaska, California, Connecticut, Illinois, Maine, Michigan, Montana, New Jersey, New Mexico, New York, Oregon and Vermont.
Another nine are very close, and the remaining 29 states fall short.
"A lot of states have invested a lot of resources into trying to do more testing, and we're seeing payoffs and we're seeing some states are able to do that basic level of testing," Jha says. "That is progress."
But even 2 million tests a day is really far from what's needed to actually slow raging outbreaks and prevent them from springing back up again, Jha explains.
The minimum targets for testing symptomatic people are based on modeling growth of current outbreaks. It assumes a modest two contacts per infection get tested, because of the difficulties many states report conducting contact tracing. Since as many as 1 out of 2 infections are spread by people without symptoms, more ambitious testing efforts are needed for communities to screen high-risk, asymptomatic people.
"Just focusing on testing people who have symptoms or their close contacts is really not enough. That has been the Achilles' heel of our entire disease outbreak control," Jha says. "We've never really had a strategy for identifying people with asymptomatic infection."
To capture those cases, Jha and his collaborators propose that communities should be testing, at a minimum: 20% of students and teachers in K-12 schools weekly; college and university students, prisoners and guards, health care workers and first responders weekly; and nursing home residents and staff twice weekly.
"What we need is a jump-start of our testing if we want to actually move to an offensive strategy around active screening of our asymptomatic individuals," says Dr. Thomas Tsai, an assistant professor in the Department of Health Policy and Management at the Harvard T.H. Chan School of Public Health, who helped conduct the testing analysis.
"It would mean that students can return to school safely. Nursing home residents and family members know that their loved ones in nursing homes and the people who work [there] can do so safely," he says.
In spite of the optimistic vaccine news, Tsai says this type of coordinated and proactive coronavirus screening is still critical to stopping the pandemic in the U.S. It will "buy time for the vaccine to be rolled out," he says.
"Testing is just as important as before vaccines," Tsai says. "The vaccine isn't an either/or strategy. Vaccines are part of the toolkit along with continued testing and masking and social distancing. In fact, it's even more important now that all of these strategies are working together to suppress the virus."
The researchers hope the incoming Biden administration will provide the federal leadership needed for a more coordinated national response to provide more testing. The proposed 6 million tests a day would probably require $10 billion to $20 billion for at least three months, the group estimates.
"It will take a real effort from the federal government, but it's not going to break the bank," Jha says.
Some other researchers say the estimate that about 2 million tests are needed as a bare minimum today may be an underestimate.
Jennifer Nuzzo, a senior scholar at the Johns Hopkins Bloomberg School of Public Health Center for Health Security, notes that the percentage of people testing positive has been increasing, suggesting that far too few people are being tested, to capture the actual infections in the community.
"We probably need to at least double the amount of testing we're doing," Nuzzo says.
Unfortunately, the increase in testing appears to have stagnated, Nuzzo notes.
"The rate at which we have increased testing in the last month is much slower compared to the previous month and yet we have more infections now than we've ever had," Nuzzo says.
Jha, Tsai and others hope the increasing availability of antigen tests could quickly increase the nation's testing capabilities and hope the targets in the new analysis will spur policymakers to make that happen.
Nuzzo hopes so too.
"Testing is slowing in the United States. We're hearing reports of shortages once again and test turnaround time increasing. All of the warning signs are there that now is the time to take this problem seriously and fix this problem for good," Nuzzo says.
A sign instructing people to wash their handsfeaturing a portrait of chief epidemiologist Anders Tegnell, the face of Swedens response to the pandemichangs at an entrance to a restaurant in Stockholm on May 10. JONATHAN NACKSTRAND/AFP via Getty Images
One month after declaring the coronavirus a socially dangerous disease in February, the Swedish Public Health Agency essentially threw up its hands and chose to seek herd immunity rather than take serious steps to mitigate the viruss spread, confidential internal documents show. That fatefuland fatalisticearly decision shaped Swedens entire response to the pandemic, from a refusal to mandate masks to a haphazard testing regime.
Swedens botched coronavirus response is no longer news: Even the countrys king, Carl XVI Gustaf, admitted in his annual Christmas address that the Swedish government had failed. But private emails seen by Foreign Policy, some of which have been previously reported in the Swedish press, reveal that Swedens health authorities were resigned to mass infectionsso called herd immunityall along, and no matter the costs. Throughout the pandemic, Swedens health authorities have said one thing publicly and something different in private about nearly every aspect of their management of the crisis. There were repeated public denials from the government that it deliberately sought to achieve herd immunity, even though that was the strategy pursued behind closed doors. There were misleading statements on the availability of testing. There was even continued public denial (despite private acknowledgement) of how the virus spreads, part of a pattern of apparent official obfuscation thats lasted the whole pandemic.
And the result has been deadly. While countries such as the United States, Brazil, and India have made headlines for recording the highest number of coronavirus-related fatalities, Swedens death rate of over 80 per 100,000 people is among Europes highest and is around 10 times as great as those of Norway and Finland, and over four times Denmarks. COVID-19 hospitalizations are now rising faster there than in most European countries, and Sweden is caring for more patients in hospital now than it did at the height of its first wave. By Dec. 21, Sweden had surpassed the United States and all major European countries in its daily confirmed cases per million. Things have gotten so out of control in Sweden that neighboring Norway, for the first time since World War II, put troops on the border to prevent Swedes from crossing over.
The Organization for Economic Cooperation and Developments Nov. 19 report concluded that Sweden fared worst among 35 European countries in multiple coronavirus management metrics including lowering the spread of infection, reducing peoples mobility, and discharging patients from intensive care units.
Swedens true handling of the pandemic matters, and not just because of how it has impacted its population of just over 10 million. Around much of Europe, and especially in the United States, Swedens hands-off approach to a deadly pandemic was, for some, a model to emulate. U.S. President Donald Trumps coronavirus advisor Scott Atlas, for example, publicly hailed Swedens approach as a model, even as its catastrophic performanceespecially when compared to its neighborsbecomes ever clearer.
A medical staffer at Sophiahemmet private hospital talks on a phone inside a tent for testing and receiving potential COVID-19 patients in Stockholm on April 7. JONATHAN NACKSTRAND/AFP via Getty Images
When the Swedish government categorized COVID-19 as a socially dangerous disease on Feb. 2, Peet Tull was sitting on a lonely farm on the Swedish island of Gotland, watching developments with concern. Tull was one of the people who built up the countrys infection control unit: He had been Public Health Agency Director Johan Carlsons boss and also given assignments to Anders Tegnell, the agencys chief epidemiologist, whom he knows well. Another thing Tull knows well is the Infection Control Act, because he participated in drafting itand he wondered why Sweden hadnt implemented a contact-tracing system or put travelers from international COVID-19 hot spots in quarantine.
As he observed global coronavirus cases surge, Tull wrote an email to Tegnell on March 15, proposing three possible options to deal with the pandemic. Option one, he said, would be to stop all movement and contacts for a four-week period. Another option, one recommended by the World Health Organization, would be to conduct intensive testing, tracking, and quarantine of infected patients. Or, he said, Sweden could pursue a third option: Let the spread of infection take place, slowly or quickly, to achieve a hypothetical herd immunity.
Tull warned: One thing is known that with option three Sweden will probably have thousands of deaths, and concluded that option three appears to me as a defeatist and headless strategy, which I would never have accepted in my previous role.
Tegnell, the state epidemiologist, answered him the same day: Well, we have walked through this and after everything landed on [option] three. We probably have a fairly extensive silent spread, which would mean that the first two would probably not work.
Tull outlined actions to take including issuing general advice and regulations for testing and contact-tracing. Tegnell demurred, arguing that such a strategy hadnt worked in Italy. Tull countered that it worked in China and South Koreaso why not in Sweden?
Right from the start of the pandemic, according to recently declassified internal emails seen by Foreign Policy, Tegnell seemed resigned to pursuing herd immunity for Swedes, seeing little chance of stopping COVID-19 through the means successfully employed in other countries such as South Korea or Vietnam.
Whether or not Sweden publicly admitted its strategy was to pursue herd immunity, other countries began to cite its approach as such. In July, according to a report in Politico, White House advisors promoting herd immunity referenced a June study by Swedens pandemic modeler, Tom Britton, which said that herd immunity could occur after just 43 percent of a population became infectedan estimate far lower than what most other epidemiologists have put forward. Britton told Foreign Policy that his calculations that Sweden would reach herd immunity turned out to be incorrect. Britton now says that U.S. government officials misinterpreted his study and that using his June research to promote herd immunity was wrong, addingthat too many people will die in order to reach herd immunity.
The Swedish and international public, though, were repeatedly told that herd immunity was not Stockholms objective.
On March 15, the day Tegnell wrote Tull they had landed on option three, Tegnell said the Public Health Agencys main tactic was not herd immunity, adding that its goal and herd immunity were not contradictory. But in public, Tegnell frequently argued that herd immunity was definitely not a goal. As recently as Nov. 18, Minister of Health and Social Affairs Lena Hallengren said that the idea that Sweden had pursued a herd immunity strategy was a rumor.
The day before his correspondence with Tull, Tegnell forwarded an email to his Finnish counterpart, Mika Salminen, which contained a recommendation from a doctor to allow people to become infected with COVID-19. One point would be to keep schools open to reach herd immunity more quickly, Tegnell wrote.
Salminen said his agency had ultimately rejected such an approach, realizing children would still spread the virus, whereas closing schools could limit the diseases impact on the elderly by about 10 percent. Tegnell, who still thought that quickly achieving herd immunity was the best strategy, responded: 10 percent might be worth it?
The next day, Tegnell forwarded a study on Italys experience with COVID-19 to Jan Albert, a professor of microbiology, who was part of a coronavirus expert group assembled a few weeks earlier by the Karolinska Institute, a university and the center of Swedens medical research community. Tegnell pointed to what seemed to be a flattening of new cases there.
Albert replied: Exactly. But most people think its just the lockdown. How much [is because of] lockdown and how much [is because of] herd immunity is really the key issue. Tegnell answered: If anyone had time, you should look at the various lockdowns that have been made and what the development looks like afterwards. I believe more in herd immunity.
Tegnell remained convinced that a rapid spread of the virus would shield Sweden, a belief that seemed to lead the countrys whole response to the crisis. A month after corresponding with Tull, Tegnell said Stockholm could achieve herd immunity in May. Three weeks later, he said: In the autumn there will be a second wave. Sweden will have a high level of immunity and the number of cases will probably be quite low, a claim he repeated into mid-October.
Carlson, Tegnells boss, echoed on Aug. 30 what Tegnell wrote Tull: It is not about us sacrificing a lot of people to achieve immunity. This model was the only one that was feasible. Our assessment has proven to be correct. The strategy must last over time. We are one of the few countries with a limited spread of infection, unlike several countries in Europe where the infection returns sharply.
It didnt work out that way. Sweden is facing an increase in cases, hospitalizations, and deaths. On Nov. 5, the country reached the grim statistic of 6,000 deaths. In the six weeks since, nearly 2,000 more have died. In the week ending Dec. 18, Sweden registered 479 new deaths, more than Norway has during the entire pandemic.
Maskless passengers wait on a crowded train platform in Stockholm on Dec. 4. Jonas Gratzer/Getty Images
The fatalistic approach taken by Swedens health authorities beginning in March shaped nearly every aspect of the countrys response to the pandemic for the rest of the year: If the coronavirus cant be successfully contained, as Tegnell and others argued in private, then why implement measures such as mask mandates, limits on retirement home visits, or restricting peoples movements?
From the very beginning, Sweden sought a different approacheven if it said publicly that it was following the same strategy as other countries. On March 4, before Swedens first official death from COVID-19, the European Centre for Disease Prevention and Control convened a meeting for European Union countries and WHO. Sweden did not participate.
A day after Tegnell corresponded with Tull, he discussed the EUs not-yet-released border recommendations, including health checks, with Andreas Johansson and others at the Ministry of Health and Social Affairs. This table contains a long list of details where we have a completely different strategy in Sweden, he wrote. Tegnell opposed border health screenings and did not support EU measures to limit case importation or exportation, arguing that since domestic spread had already begun in most countries, border limits would be relatively meaningless.
The very next day, March 17, Tegnell said on television that he did not think there was any difference between what other countries were doing and what Sweden was attempting. I do not think these strategies are different, we are talking about exactly the same thing in both strategies, he said.
That was the same day that countries such as the United Kingdom, which had flirted with a strategy of herd immunity, switched to a strategy of suppression after the release of a study by Imperial College that concluded that such an approach was the only viable strategy at the current time to prevent 250,000 British deaths. But the Swedish Public Health Agency and advisory health experts discounted the studys findings and kept seeking herd immunity, emails show.
Sweden relied on advice to wash hands; other voluntary measures, such as that people stay home when sick, limit unnecessary travel, and work from home if possible, were advised only after there was already community spread in the country. The government limited public gatherings to 50 peoplebut not until March 27. And then, as the country began to see a rise of cases in October, the government increased the event limit to 300 people on Oct. 22, which the government then decreased to eight effective on Nov. 24 as cases, hospitalizations, and deaths continued to rise.
Throughout the pandemic, Stockholm issued no general national mask recommendations, not even for general elder care, unless there was evidence patients had the coronavirus. The governments official health guidance still casts doubt on the efficacy of wearing masks, even as authorities in most other countries have come to appreciate the role that masks play in limiting the spread of an airborne virus. But then Swedish health authorities remain unconvinced the virus even is airborne, officially telling citizens COVID-19 does not count as an airborne infection. On Dec. 18, the government announced that the Public Health Agency would draw up recommendations for wearing masks during crowded commuting hours on public transit, but those will only come into force after Jan. 7. The updated official advice includes the line, We do not currently recommend a broad use of masks in society, and continues to cast doubt on the scientific evidence for masks, even saying that masks may provide a false sense of security.
Unlike in neighboring countries, bars, restaurants, and gyms remained open. Compulsory in-person schooling continued through middle school; high school and post-secondary education moved online on March 17. Not until March 24, two weeks after the risk level was raised to the highest level, was the general public encouraged to socially distance if possible. Nursing homes stayed open to visitors until April 1.
While neighbors began to introduce curbs on public life and speed up testing, Sweden did neither. Denmark, which entered a short lockdown on March 17, began easing it when it announced the beginning of widespread testing on March 30. Internal emails show it wasnt until Denmark implemented its testing plan that the Swedish government and the Public Health Agency even began discussing one.
Whether authorities were talking about herd immunity, access to hospital care, how the virus spreads, or how testing was determined, Sweden told one story in public and a different one in private.
Prime Minister Stefan Lofven declined to be interviewed, but a spokesperson said: Herd immunity is not a strategy, but a potential consequence of how the spread of the virus develops. Herd immunity has never been a part of the Swedish Governments strategy. Lofven, through a spokesperson, previously said that Swedens strategy is not much different from other countries, yet Sweden is the only democratic country in the world that does not mandate even limited use of masks.
A full government reckoning of the handling of the pandemic wont be made public until 2022, but an interim report on the spread of the virus in nursing homes was released on Dec. 15. It noted that government measures were late and inadequate, and called the spread of the virus in society the single most important factor behind the major outbreaks and the high number of deaths in residential care.
Carlson, Tegnell, and Hallengren did not respond to requests for comment. Ebba Busch, the leader of the opposition Christian Democrats party, said in June that the government actively and openly chose a strategy that would mean a higher degree of contagion in society, calling the quest for herd immunity naive.
A nurse checks the blood on an extracorporeal membrane oxygenation machine as she takes care of a COVID-19 patient in the Karolinska University Hospital in Solna, near Stockholm, on April 19. JONATHAN NACKSTRAND/AFP via Getty Images
The results of that quest for elusive herd immunity are sadly well known. By the end of May, when some neighbors reopened without seeing big spikes, Swedes were restricted from traveling to many countries.
Contrary to the expectations of Tegnell and others, the quest for herd immunity neither materialized nor shielded Sweden from the ravages of a second wave in the autumn. The Public Health Agencys reports from June showed the level of people with coronavirus nationwide to be 7.1 percent, far from the 60-75 percent experts say is needed.
Finally, on Nov. 24, Tegnell said that Sweden may be in the peak of a second wave, despite having argued the opposite along with Carlson for months.
One man at least, Tull, had seen what was coming and tried to warn experts not to make matters worse. In his final email to Tegnell on March 15, Tull, who had worked to eradicate smallpox in Bangladesh, implored health authorities not to throw up their hands and to give science and precautionary measures a chance.
You cannot just watch when you fear that a large number of people may die, he wrote. Every effort must be made to prevent this from happening. It is not enough to believe that it is not possible.
TAMPA After today, diagnostic tests for the coronavirus will be unavailable at Hillsborough Countys public sites until Monday.
All sites will be closed Dec. 24-27 and again Jan. 1-3 because of the holidays.
The countys COVID-19 testing and information line, (888) 513-6321, will remain open 24 hours a day during the holidays for general questions. However, it will be unavailable for appointment scheduling on Christmas Eve, Christmas Day and New Years Day. For information, see the countys Web site at HCFLGov.net/COVIDTesting.
The test sites at the Vance Vogel Sports Complex, 13012 Bullfrog Creek, Riverview, and the William Owen Pass Sports Complex, 1300 Sydney Dover Road, Dover, will be open Monday Dec. 28 and Wednesday, Dec. 30. The normal schedule of operating Monday, Wednesday and Friday resumes Jan. 4. Appointments are required.
The Lee Davis Community Resource Center, 3402 N. 22nd St., Tampa, will be open 8 a.m. to 4 p.m. Dec. 28-30 and 8 a.m. to noon Dec. 31. Its normal schedule of operating Monday through Thursday resumes Jan. 4. No appointments are needed and testing is done on a first-come, first-serve basis.
Testing at Raymond James Stadium, 4201 N. Dale Mabry Highway, Tampa, resumes 8 a.m. to 4 p.m. Dec. 28-30 and 8 a.m. to noon Dec. 31. It will be open again at 8 a.m. Monday, Jan. 4 and resume its usual Tuesday-through-Saturday schedule the next day.
Testing at the stadium also is done on a first-come, first-serve basis with no advance scheduling of appointments.
As of last week, the countys public locations and its mobile unit had conducted more than 171,000 tests for the coronavirus, or 23 percent of the 746,300 tests that had been administered in Hillsborough County.
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The analysis, of 10,789 paired test results from 1,333 white patients and 276 Black patients hospitalized at the University of Michigan earlier this year, found that pulse oximetry overestimated oxygen levels 3.6 percent of the time in white patients, but got it wrong nearly 12 percent of the time, or more than three times more often, in Black patients.
In these patients, the pulse oximeter measures erroneously indicated the oxygen saturation level was between 92 and 96 percent, when it was actually as low as 88 percent (the results were adjusted for age, sex and cardiovascular disease).
Confused by the terms about coronavirus testing? Let us help:
Oxygen levels below 95 percent are considered abnormal, so a small difference in pulse oximetry value in this range of 92 to 96 percent could be the difference in deciding whether the patient is really sick or not really sick, or needs different treatment or not, Dr. Sjoding said.
Another analysis in the study examined a multi-hospital database to compare 37,308 similar paired test results from intensive care patients who had been hospitalized at 178 medical centers in 2014 and 2015. That analysis, which was not adjusted, found similar discrepancies.
Dr. Sjoding said he and his colleagues embarked on the study after hospitals in Ann Arbor, Mich., which typically care for a predominantly white patient population, received a large influx of critically ill Covid patients from Detroit many of whom were African-American. We started seeing some discrepancies with arterial blood gas, and we didnt know what to make of it, he said.
He recalled reading an article published in The Boston Review in August about racial disparities in the accuracy of pulse oximeter readings. The writer of that article, Amy Moran-Thomas, an anthropologist at M.I.T., became interested in the device after buying one when her husband was sick with Covid. She dug up scientific papers published as far back as 2005 and 2007 that reported inaccuracies in pulse oximeter readings in dark-skinned individuals at low oxygen saturation levels.
Dr. Sjoding and his colleagues decided to do a study using data that had already been collected during routine inpatient care at the hospital. What we were seeing anecdotally was exactly what we ended up showing in the final paper, that on the monitor in the patients room, the pulse oximeter would be reading normal, but when we got an arterial blood gas, the saturation on the gas was low, he said.
The royals, including the Duke and Duchess of Cambridge and their children, were photographed in close proximity to other family members in a park on Sunday, according to British media outlet the Mail Online.Prince William and his family were walking alongside his uncle Prince Edward and his family while visiting a Christmas-themed woodland walk near the Queen's Norfolk residence Sandringham, according to the Mail Online.
Photos shared by the outlet appear to show more than six individuals present, with the two families standing in close proximity while visiting Luminate Sandringham.
Norfolk falls under England's Tier 2 coronavirus restrictions, limiting outdoor gatherings to six people.
Visitors to the attraction are asked to remain in groups of no more than six throughout their visit, according to guidance issued by the organizers of the woodland walk, Luminate Sandringham.
In response to the article, a source at Sandringham told CNN that "there were moments on the 90 minute walk where it was difficult to keep the two family groups apart, particularly at bottlenecks on the trail."
"The two families were given separate consecutive slots to visit the trail just before it opened to the general public. They arrived, and departed in their own family groups," the source added.
At the weekend, Prime Minister Boris Johnson imposed stricter measures -- Tier 4 -- on London and other areas in southeastern England.
Those living in Tier 4 areas have been asked to not visit the attraction, which is located in a Tier 2 area, according to the organizers.
"Please be assured, that the health and safety of our visitors and staff remains at all times our paramount consideration, particularly with regards the ever evolving Covid 19 pandemic," Luminate said in a statement on its website.
"We would ask that all of our visitors be respectful of other visitors and our colleagues throughout your visit," Luminate added.
As part of new coronavirus regulations issued by the government ahead of Christmas, those residing in Tier 2 areas have been asked to limit outdoor meetings to no more than six, including children of any age.
"You can continue to meet in a group larger than six if you are all from the same household or support bubble or another legal exemption applies," the UK Department of Health and Social Care said Saturday.
LITTLE VILLAGE Since losing her job earlier this year, Little Village resident Camila has frequented New Life Centers Pan de Vida food pantry a few times a month to pick up vegetables, meat and milk.
The coronavirus pandemic has had a big impact on Camilas family of five. And as shes lined up for food, she noticed the line at the pantry at 27th Street and South Lawndale Avenue grow week after week.
In the face of uncertainty, the pantry has been a lifeline for her family, she said.
Its a big help, Camila said in Spanish.
Hoping to meet some of the unprecedented need for food assistance, New Life Centers and the Greater Chicago Food Depository partnered to give away turkey, ham and holiday fixings ahead of Christmas to more than 2,500 families Tuesday morning.
National nonprofit Feeding America estimates 785,890 people in Cook County are food-insecure. Theres been a 51 percent increase since 2018, according to a Greater Chicago Food Depository analysis.
That makes Cook County the third-largest population of food-insecure people in the United States.
The Greater Chicago Food Depositorys network of food pantries and partners have recorded up to 150 percent increases in people needing food assistance during the pandemic, according to its year-end report.
Its the biggest hunger crisis the Greater Chicago Food Depository has seen in its 41-year history. And even with a vaccine on the horizon, the nonprofits leaders expect the economic recovery from the pandemic and as a result, food insecurity to take months or even years to level off, according to the report.
Greater Chicago Food Depository spokesman Greg Trotter said they are working to get grants and fundraise so food pantry partners can continue to meet the need on the ground.
People are really hurting hundreds of thousands of people in Cook County, Trotter said. One of the few silver linings has been partnerships with groups like New Life Centers.
Before the pandemic, New Life Centers distribute food out of the churchs basement, helping about 100 families per week thanks to donations from Trader Joes.
When COVID hit, we saw the need spike like crazy, New Lift Centers Executive Director Matt DeMateo said.
After teaming up with the Greater Chicago Food Depository in April, New Life Centers has been able to scale up distribution at seven sites across the South and West sides, DeMateo said, feeding more than 700,000 people in six months.
New Life Centers is working to open a permanent food pantry in the coming months, DeMateo said.
Systemic inequities over generations have led to disproportionate rates of poverty and food insecure among Black and Latino families. Black and Hispanic households face food insecurity at rates more than double those of white households, according to the U.S. Department of Agriculture.
The coronavirus crisis has worsened disparities, leaving people of color more like to contract coronavirus and suffer from the economic fallout. A recent Northwestern University study showed that four in 10 Black and Latino households with children report they are food insecure.
In Little Village, a working-class, majority Latino neighborhood on the South Side, youth volunteers and staff have stepped up in extraordinary ways to help families through this difficult time, DeMateo said.
Diana Franco, 20, who formerly attended youth programs there, started volunteering after the pandemic and then joined the Pan de Vida staff.
I wanted to help and I saw the need, Franco said. COVID has impacted the community a lot and having the pantry has helped a lot.
We see people from far away because they are in need.
Brighton Park resident Mari Ybarra takes two buses to get to Little Village twice a month because the food distribution helps her get by, she said. She also goes out so her pregnant daughter doesnt have to leave home and risk contracting the virus, Ybarra said.
This helps a lot, Ybarra said. It goes a long way.
Adding to the ambiance at the food pantry Tuesday, a youth mariachi band played for neighbors. DeMateo said organizers wanted to provide neighbors with a celebration after a heavy year.
Christmas is going to be a difficult season for a lot of families. A lot of our families are still unemployed, struggling and weve lost close to 200 people in the 60623 [ZIP code] alone to COVID, DeMateo said.
We are here to provide hope, healing and community as best as we can.
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